All PlansPrior AuthMedium impact
Authorization Requirement Update for Vision Services
Healthfirst·Ophthalmology·Prior Authorization
Effective date
May 1, 2023
We identified it
Jun 20, 2026
Summary
Effective May 1, 2023, Healthfirst no longer requires prior authorization for three specific vision services: pterygium procedures (CPT 65420, 65426) and laser trabeculoplasty (CPT 65855). This eliminates authorization delays for these ophthalmology procedures.
Action Required
Immediately: Update billing system to remove prior authorization requirements for CPT codes 65420, 65426, and 65855 for Healthfirst plans. Notify ophthalmology providers these procedures no longer need pre-authorization. Update encounter forms and workflow documentation to reflect these changes.